Book of Quantum
June 2004 Version 1
Table of Contents
FOREWORD
Background
Book of Quantum
Level of compensation
1
1
1
2
HOW TO USE THIS BOOK
How assessments are calculated
Identify a category of injury
Understand the Severity of the injury
Look up the value range
Consider the effect of multiple injuries
Sample assessment
3
3
3
4
4
4
4
HEAD INJURIES
5
Skull / Brain
Skull fracture (no loss of consciousness)
Skull fracture with intracranial injury (no loss of consciousness)
Skull fracture (with loss of consciousness)
5
5
5
5
Nose
Fracture
6
6
Cheek
Fracture
6
6
Jaw
Soft tissue injuries
Dislocation
Fracture
6
6
6
7
Teeth
Loss of Milk Tooth
Broken Tooth
Loss of Tooth
7
7
7
7
ARM INJURIES
8
Arm Amputations
8
Shoulder / Upper Arm (humerus and scapula bones)
Soft Tissue
Dislocation
Fracture
8
8
9
9
Elbow / Forearm (radius and ulna bones)
Soft Tissue
9
9
June 2004 Version 1
Dislocation
Fracture
10
10
Wrist
Soft Tissue
Dislocation
Fracture
11
11
11
11
Hand
Soft Tissue
Fractures
Crush Injury
12
12
12
12
Thumb and Fingers
Soft Tissue
Dislocation
Fracture
13
13
13
14
Skin Disorders (Arm and Hand)
14
NECK BACK AND TRUNK INJURIES
15
Whiplash and other Soft Tissue Injuries
Neck
Back
15
15
15
Spinal Cord Injuries
Vertebra
Rib(s) or Chest Bone
16
16
17
Crush Injuries
17
Internal Injuries
Heart
Lung
Kidneys
Bowels and Digestive System
Bladder
Spleen
Hernias
17
17
18
18
19
19
20
20
LEG INJURIES
21
Leg Amputations
21
Hip/Pelvis
Soft Tissue
Dislocations
Fractures
21
21
21
22
Upper Leg (femur bone)
Fractures
22
22
June 2004 Version 1
Knee
Soft Tissue
Dislocations
Fractures
23
23
23
23
Lower Leg (tibia and fibula bones)
Fractures
24
24
Ankle (including Achilles Tendon)
Soft Tissue
Dislocations
Fractures
24
24
25
25
Foot
Soft Tissue
Dislocations
Fractures
Crush Injuries
26
26
26
26
27
Toes
Dislocation
Fractures
27
27
28
June 2004 Version 1
PIAB Book of Quantum
Foreword
Background
This Book of Quantum (quantum means AMOUNT) has been compiled on behalf of the new
Personal Injuries Assessment Board (PIAB) by independent consultants. It is an aid in the
assessment of compensation to which a person (claimant) may be entitled when injured due
to the fault of another (respondent). The Book of Quantum should also encourage negotiated
settlements between parties where it is accepted that the injured party has an entitlement to
compensation.
PIAB will
•
Provide an independent compensation assessment service to the benefit of both
claimants and respondents where legal issues are not in dispute
PIAB will not
•
Make payments of compensation. Subject to the acceptance of the assessment by
both parties the compensation will be paid directly by the respondent to the claimant.
The establishment of PIAB is a key measure in the Government’s Insurance Reform
Programme, the aim of which is to tackle the high cost of insurance in Ireland. The key
objectives of PIAB are to
•
•
Significantly reduce the delivery cost of awarding compensation due to claimants,
without altering the level of compensation
Implement a less adversarial and faster settlement process for personal injury claims
where claimants have an entitlement to compensation
PIAB will only be involved where the question of fault is not at issue.
Book of Quantum
To obtain an indication as to the likely range of compensation for a particular injury, the Book
of Quantum contains a guideline of injuries and related values. Some of the value ranges
displayed are quite wide and this reflects the fact that the severity of injury, even within the
categories listed, can vary considerably. In addition, the same injury can have different
effects on different people.
The values quoted do not represent the views of PIAB or any other parties and reflect the
reality of current compensation levels.
The categories of injury are based on the World Health Organisation’s International
Classification of Diseases version 9 and follow a simple structure of body region / body part /
injury type.
The Book only deals with compensation for pain and suffering. A claimant may also be
entitled to claim under other headings for actual financial losses.
It is not intended that this should be a detailed medical encyclopedia in terms of either
content or terminology. While on the one hand ensuring that it is sufficiently comprehensive to
cover the vast majority of injuries, it is also intended that it should be easy for you to
understand and follow.
The content of the Book of Quantum will be kept under review.
June 2004 Version 1
1
PIAB Book of Quantum
Level of compensation
PIAB assessments will be in line with current levels of compensation. PIAB assessors will be
guided by the values in this Book. Assessments will not be rigid and will have full regard to
the specifics of each individual case.
Compensation may be payable for injury types other than those that appear in this Book.
June 2004 Version 1
2
PIAB Book of Quantum
How to use this book
Introduction
This book has been compiled as a guide to the general level of compensation that a person
may expect to receive if unfortunate enough to have been injured due to the fault of another.
While the guide has been graded to reflect the severity of the injury sustained, it is recognised
that even within these grades, the actual degree of severity can vary considerably and the
same injury can have different consequences for different people. The majority of cases fall
within the ranges shown but these are neither minimum nor maximum figures for the category
of injury involved as each case will be dealt with on its individual facts.
Consequently, full recognition of how an injury has affected a claimant personally will always
be considered and reflected in any assessment made by PIAB.
How assessments are calculated
This book only reflects compensation for pain and suffering which is supported by appropriate
medical evidence. An assessment has a number of components, covering some or all of the
following:
• A sum to compensate for pain, suffering and loss of enjoyment of life
• Specific losses such as past loss of earnings and medical bills.
• Future cost of medical care
• Loss of earnings into the future caused by the injury
PIAB will assess a claim in its entirety including all components appropriate to the case that
have been vouched.
Follow the steps set out below to understand what assessment range may be appropriate for
an injury
• Identify a category of injury
• Understand the severity of the injury using the medical report on the claimant
• Look up the value range
• Consider the effect of multiple injuries
Identify a category of injury
Assessment of compensation starts by identifying that part of the body that has suffered the
most significant injury although the complete effect of all the injuries will be considered.
The Book is separated into four main categories.
•
•
•
•
Head
Arms
Neck, back and trunk
Legs
Consult the Contents page for the specific injury category and type, which will direct you to
the relevant page. Injuries are then generally categorised into three levels of severity with a
range of values provided for each level as a guide. Some ranges are quite wide, reflecting
how the same injury can have very different effects on different people.
Compensation may be payable for injury types other than those that appear in this book.
Every injury will be considered in its entirety by PIAB. This Book only deals with cases where
a claimant has suffered significant injuries. Cases of minor injury will involve much lower
levels of compensation.
June 2004 Version 1
3
PIAB Book of Quantum
Understand the Severity of the injury
Any individual injury may produce different effects according to the nature and severity of the
accident and personal features such as age, physique, pre-existing medical condition or predisposition of the person or indeed other factors. This Book categorises severity into three
broad ranges namely.
•
Substantially Recovered
Covers injuries from which a claimant has substantially recovered but there are
ongoing symptoms that interfere with carrying out full day to day activities.
•
Significant Ongoing
Includes the above and in addition the injury has resulted in some permanent
incapacity or limitation that significantly restricts or alters lifestyle.
•
Serious and Permanent Conditions
Will apply if the injury is very severe and has caused major disruption to a claimants
life in a number of areas or results in serious continuing pain and/or requires
permanent medical attention.
Please note that all claims need to be supported by medical evidence.
Look up the value range
After identifying the category and severity of the injury go to the relevant section (as set out in
the contents page) where the guideline values are detailed. The majority of cases fall within
that range but it is neither a minimum nor a maximum for individual cases.
Consider the effect of multiple injuries
If, in addition to the most significant injury as outlined above, there are other injuries, it is not
appropriate to add up values for all the different injuries to determine the amount of
compensation. Where additional injuries arise there is likely to be minor adjustment within
the value range.
Sample assessment
Claimant sustained soft tissue injuries and the award was assessed on the following basis;
General Damages for pain and suffering
€7,200
Special Damages
Net loss of earnings
€400
Medication
€126
Physiotherapy
€200
Doctors fees
€150
Total settlement
June 2004 Version 1
€8,076
4
PIAB Book of Quantum
Head injuries
Skull / Brain
Skull fractures are classified as being linear (most common), depressed, or comminuted
fractures that are further classified as closed or open (compound). A closed fracture is
one in which there is no scalp or outside communication through the line of fracture.
Intracranial injuries, including brain contusions and lacerations are severe head injuries.
It is impossible to be too specific about the compensation levels for these types of
injuries due to the high number of variables involved and the number and severity of
possible outcomes (e.g. personality and behavioural disorders). As with all cases, each
one will differ and be considered on its individual merits with the figures being displayed
here as a rough guide.
Skull fracture (no loss of consciousness)
Substantially recovered
€23,300 to €35,700
Significant ongoing
€28,500 to €69,200
Serious and permanent conditions
€61,000 to €96,700
Skull fracture with intracranial injury (no loss of consciousness)
Substantially recovered
€31,300 to €39,500
Significant ongoing
€37,900 to €75,700
Serious and permanent conditions
€70,400 to €103,000
Skull fracture (with loss of consciousness)
Substantially recovered
€23,300 to €107,000
Significant ongoing
€28,500 to €113,000
Serious and permanent conditions
€61,000 to €129,000
June 2004 Version 1
5
PIAB Book of Quantum
Nose
Fracture
Because of its prominence (and therefore vulnerability) and structural weakness, the
nose is the most frequently fractured facial bone.
Serious injuries are likely to have an element of facial disfigurement attached to them
and will be considered accordingly. Hence why only one category is included here.
Substantially recovered
€14,900 to €19,600
Cheek
Fracture
Cheek fractures (the zygoma bone) tend to be unilateral (i.e. one-side only), and result in
flattening of the cheek. Eye socket fractures often accompany cheek fractures resulting
in changes in appearance of the eyeball such as a sunken appearance. Nerve injuries
are also often seen with cheek fractures sometimes leaving ongoing symptoms (e.g.
tingling sensation) of the face.
Serious injuries are likely to have an element of disfigurement attached to them and will
be considered accordingly.
Substantially recovered
€16,500 to €25,400
Jaw
Soft tissue injuries
A jaw sprain is an unusual sprain and this is why only two categories are present for this
injury. This category is for sprains of the joint between the top and bottom jaws (the
Temporomandibular Joint).
Substantially recovered
up to €35,100
Serious and permanent conditions
€33,900 to €65,800
Dislocation
June 2004 Version 1
6
PIAB Book of Quantum
A jaw dislocation is a dislocation of the lower jawbone (mandible). Jaw dislocations are
usually reduced by closed manipulation. Analgesics and a soft diet may be prescribed,
or even a cervical collar.
Substantially recovered
€16,500 to €25,600
Significant ongoing
€25,100 to €53,700
Serious and permanent conditions
€49,200 to €73,800
Fracture
After the nose, the jaw (mandible) is the most commonly fractured facial bone. Some
jaw fractures may be very simple and require only observation and soft diet or with just
bandage immobilisation but the majority of fractures require internal fixation with the use
of wires.
Substantially recovered
€16,500 to €27,900
Significant ongoing
€25,000 to €58,000
Serious and permanent conditions
€49,200 to €78,000
Teeth
Loss of Milk Tooth
€3,600 to €5,700
Broken Tooth
€6,000 to €11,100
Loss of Tooth
June 2004 Version 1
€5,300 to €12,800
7
PIAB Book of Quantum
Arm Injuries
Arm Amputations
Complicated traumatic amputations are ones involving delayed treatment, delayed
healing or major infection. The necessity for stump revision or the existence of phantom
limb pains may also occur.
Amputations of fingertips are included in the individual finger ranges.
Loss of both arms
€141,000 to €197,000
Loss of both hands (below elbow amputation)
€136,000 to €192,000
Loss of one arm above elbow
€111,000 to €145,000
Loss of one hand (below elbow amputation)
€108,000 to €142,000
Loss of Thumb
€33,900 to €80,800
Loss of Ring, Index or Middle Finger(s)
€28,800 to €69,300
Loss of Little Finger(s)
€28,800 to €50,400
Shoulder / Upper Arm (humerus and scapula bones)
Soft Tissue
The level and duration of treatment as well as any complications and permanent ongoing
disability will dictate the level of compensation.
This category includes all sprains to the upper arm and shoulder region including partial
and complete tears of the tendons forming the joint capsule (the rotator cuff), which may
result in substantial reduced capacity.
Substantially recovered
up to €22,600
Significant ongoing
€14,800 to €51,500
Serious and permanent conditions
€41,000 to €71,600
June 2004 Version 1
8
PIAB Book of Quantum
Dislocation
Shoulder dislocations range from simple dislocations to more severe with ligament and
nerve damage. Likewise, the level of treatment can range from placing the arm in a sling
to operative reduction. Once dislocated, the shoulder may be susceptible to further
dislocation in the future with the increased risk of degenerative disease as a result.
Substantially recovered
€14,600 to €25,600
Significant ongoing
€20,200 to €54,600
Serious and permanent conditions
€46,400 to €74,500
Fracture
Fractures of the humerus (upper arm bone) may also be described according to the type
of fracture, for example transverse, oblique, spiral or comminuted.
They are most often treated very conservatively by non-surgical means, for example
closed reduction and/or cast and sling. Uncommonly, open reduction is necessary.
Complications of humerus fractures may include nerve palsy and delayed and non-union
and shoulder joint stiffness. Very occasionally, brachial artery complications may be
seen with shaft fractures.
Healing times can vary with some fractures being slow to heal although this depends
upon the degree if any, of displacement.
Substantially recovered
€15,400 to €29,300
Significant ongoing
€21,000 to €72,400
Serious and permanent conditions
€46,900 to €82,900
Elbow / Forearm (radius and ulna bones)
Soft Tissue
Elbow sprains are typically treated conservatively. Rest, ice packs and heat applications
and in some cases temporary immobilisation in a sling or bandage is usually all that is
needed. In some cases, anti-inflammatory medication may be prescribed physiotherapy
may be of some assistance.
June 2004 Version 1
9
PIAB Book of Quantum
Elbow sprains generally heal without any residual effects and in this event will fall in
either of the lower two brackets dependent on prognosis.
Substantially recovered
up to €20,600
Significant ongoing
€15,500 to €52,100
Serious and permanent conditions
€44,900 to €72,300
Dislocation
Some cases require open reduction of the dislocation rather than the more common
closed reduction. Complications can arise where vein damage also occurs due to
swelling and the need to hold the elbow in a flexed position following reduction.
Substantially recovered
€16,500 to €25,100
Significant ongoing
€23,100 to €57,000
Serious and permanent conditions
€52,400 to €76,300
Fracture
It is more common to encounter fractures of both forearm bones rather than isolated
fractures of either the ulna or radius. If caused by direct trauma the fracture line usually
occurs at the same level in both bones, if indirect trauma the fractures can occur at
different levels. Fractures that involve the joint are usually considered more complicated
than others due to the increased impact on limb movement.
Substantially recovered
€17,100 to €29,500
Significant ongoing
€23,800 to €65,500
Serious and permanent conditions
€53,400 to €82,800
June 2004 Version 1
10
PIAB Book of Quantum
Wrist
Soft Tissue
In addition to general wrist sprains, which often fully recover, this category should be
used for the specific wrist injuries of Repetitive Strain Injury (Tenosynovitis), Carpal
Tunnel Syndrome, Cubital Tunnel Syndrome and Radial Tunnel Syndrome.
Substantially recovered
up to €26,200
Significant ongoing
€15,500 to €70,100
Serious and permanent conditions
€26,000 to €88,600
Dislocation
Again the more complicated dislocations will involve Serious and permanent conditions
treatment such as open reduction. They may have complications such as medial nerve
compression and result in a permanent condition.
Substantially recovered
€15,800 to €25,800
Significant ongoing
€22,600 to €62,400
Serious and permanent conditions
€55,300 to €79,100
Fracture
The wrist contains many bones (radius, ulna and eight carpal bones) of which the
scaphoid carpal bone is the most commonly fractured. In view of this complexity and
variety it is difficult to provide very specific ranges for “wrist fracture”. Fractures that
involve the joint are usually considered more complicated than others due to the
increased impact on limb movement.
Substantially recovered
€15,600 to €25,200
Significant ongoing
€22,400 to €61,800
Serious and permanent conditions
€55,400 to €79,500
June 2004 Version 1
11
PIAB Book of Quantum
Hand
Soft Tissue
Like other sprains, hand sprains are sometimes classified in grades: mild sprains involve
some stretching of ligaments, moderate sprains involve partial rupture of a ligament
while severe sprains involve complete rupture of a ligament. Although the injury may last
for several months, a full recovery is the most common outcome.
Substantially recovered
up to €26,200
Significant ongoing
€15,500 to €70,100
Serious and permanent conditions
€26,000 to €88,600
Fractures
Fractures to the hand (the metacarpal bone(s)) are described according to the site of the
fracture; they may involve the base of the bone, the shaft, or the neck and head.
Substantially recovered
€13,200 to €22,000
Significant ongoing
€20,200 to €67,500
Serious and permanent conditions
€60,500 to €86,600
Crush Injury
A crush injury is a serious type of soft-tissue injury and may include fracture, vein and
nerve damage.
Treatment of these major soft-tissue injuries can involve vein repair, nerve repair,
debridement, repeated wound irrigations and skin grafts. Amputation may become
necessary unless the neurovascular viability of the limb or part thereof is restored. Any
associated fractures and other soft tissue damage such as ligament and tendon injuries
will also require repair.
Substantially recovered
€13,100 to €25,000
Significant ongoing
€14,800 to €69,800
Serious and permanent conditions
€23,100 to €88,400
June 2004 Version 1
12
PIAB Book of Quantum
Thumb and Fingers
Soft Tissue
Like other sprains, hand sprains are sometimes classified in grades: mild sprains involve
some stretching of ligaments, moderate sprains involve partial rupture of a ligament
while severe sprains involve complete rupture of a ligament.
Although the injury may last for several months, a full recovery is the most common
outcome.
Thumb
Substantially recovered
up to €18,200
Significant ongoing
€14,500 to €40,800
Serious and permanent conditions
€36,500 to €63,400
Substantially recovered
up to €16,800
Significant ongoing
€10,300 to €29,800
Serious and permanent conditions
€17,900 to €47,800
Finger(s)
Dislocation
More severe dislocations may involve the head of the bone protruding into the joint
capsule and here, closed reduction is probably not possible and surgical reduction is
carried out. Otherwise, it is most common for reduction to be attempted by closed
means and the finger splinted. Substantial recovery is the most common outcome for
these injuries.
Thumb
Substantially recovered
€13,100 to €18,900
Significant ongoing
€17,400 to €43,000
Serious and permanent conditions
€39,300 to €65,200
June 2004 Version 1
13
PIAB Book of Quantum
Finger(s)
Substantially recovered
€12,200 to €17,500
Significant ongoing
€13,700 to €31,300
Serious and permanent conditions
€22,000 to €49,100
Fracture
Most thumb and finger fractures are simple fractures and are treated non-operatively. In
fact some don’t require any treatment at all.
Others are, for example where it’s open (breaks the skin) or closed will have a bearing
on the compensation given. Complications such as non-union of fractures are rare but
malunion does sometimes occur with deformity and restriction of function. Posttraumatic
arthritis is also a possible late complication.
Thumb
Substantially recovered
€14,000 to €20,700
Significant ongoing
€18,600 to €44,800
Serious and permanent conditions
€40,500 to €66,800
Substantially recovered
€13,100 to €19,100
Significant ongoing
€14,800 to €33,100
Serious and permanent conditions
€23,200 to €50,800
Finger(s)
Skin Disorders (Arm and Hand)
Contact allergic dermatitis is a reaction of the skin to allergens (substances which the
body is allergic to). Whilst not confined to the arm and hand, this is the most common
area affected. Allergens generally don't cause skin reactions to most people but some
are hypersensitive to the allergens, which are usually organic or chemical in nature.
Substantially recovered
€12,300 to €14,900
Serious and permanent conditions
€28,800 to €70,400
June 2004 Version 1
14
PIAB Book of Quantum
Neck Back and Trunk Injuries
Whiplash and other Soft Tissue Injuries
The most common type of neck injury is called a “whiplash” injury which is an over
extension or sprain often suffered in a motor vehicle accident. Whiplash injuries can
involve a very minor sprain that heals within weeks or they can in extreme cases cause
long lasting pain and permanent disability.
Neck and Back
Whiplash symptoms may be minor, acute or chronic. Many individuals who suffer
whiplash recover within months of their injury. Some whiplash injuries can cause
symptoms to persist for several years. Chronic symptoms may involve injections of local
anaesthetic for pain relief, or cortisone/steroid and muscle relaxants or the use of a
TENS machine or ultrasound.
Sometimes a neck or back strain can irritate or aggravate a pre-existing condition that
may or may not have been treated before the accident. These can include disc lesions;
spondylosis; osteoarthritis; spondylolithesis; and spinal stenosis.
Serious injuries may involve partial or complete damage to the spinal nerves, serious
exacerbation of disc lesions requiring fusing of vertebra, irritation of a spinal nerve root,
and those most severe back injuries not involving paralysis, but with severe
consequences such as loss of sexual function or loss or impairment of urinary or bladder
function.
Neck
Substantially recovered within 12 months
up to €14,400
Substantially recovered within 24 months
€11,500 to €17,400
Significant ongoing
€15,900 to €64,500
Serious and permanent conditions
€59,400 to €78,400
Substantially recovered within 12 months
up to €16,300
Substantially recovered within 24 months
€11,700 to €19,600
Significant ongoing
€18,300 to €69,700
Back
June 2004 Version 1
15
PIAB Book of Quantum
Serious and permanent conditions
€62,800 to €85,900
Spinal Cord Injuries
Quadriplegia is paralysis of all four limbs with paraplegia being paralysis of both lower
limbs and partial or total loss of urinary and bowel function, due to spinal cord disease or
injury.
The courts set the maximum compensation with the exact value being based on a
number of considerations:
a)
b)
c)
d)
level of movement
level of pain and suffering
depression – level of achievable rehabilitation
age and life expectancy
Quadriplegia
up
to
€300,000
Paraplegia
up
to
€300,000
Vertebra
This category includes all types of vertebral fractures including fracture dislocations;
wedge fractures; chance fractures; burst fractures and flexion tear drop fractures.
Wedge spinal fractures are regarded as stable fractures and rarely result in neurological
complications. These occur most commonly in the thoracic spine.
Burst fractures are regarded as stable fractures but may result in spinal cord involvement
if there is bone fragmentation.
Substantially recovered
€22,100 to €76,500
Significant ongoing
€30,500 to €86,700
Serious and permanent conditions
€62,700 to €101,000
June 2004 Version 1
16
PIAB Book of Quantum
Rib(s) or Chest Bone
Although severe pain may follow injury, most rib fractures achieve substantial recovery in
a relatively short period of time without treatment. Some may involve ongoing residual
permanent condition and some have complications such as a punctured lung.
Substantially recovered
€12,700 to €27,200
Significant ongoing
€20,500 to €78,700
Serious and permanent conditions
€65,900 to €82,300
Crush Injuries
A crush injury is a serious type of soft-tissue injury and may include fracture, vein and
nerve involvement.
Treatment of these major soft-tissue injuries involves vein repair, nerve repair,
debridement, repeated wound irrigations and skin grafts. Any associated fractures and
other soft tissue damage such as ligament and tendon injuries will also require repair.
Substantially recovered
€13,100 to €31,600
Significant ongoing
€20,700 to €83,100
Serious and permanent conditions
€66,300 to €86,500
Internal Injuries
Heart
A heart contusion is bruising of the heart muscles. It usually occurs from severe blunt
trauma to the chest causing the chest bone to compress the heart against the spinal
column. This trauma leads to an alteration in the heart cells fluid composition, which in
turn lead to an alteration in the hearts electrical activity and leads to abnormal heart
rhythm. This rhythm activity is usually temporary. Clinical signs of contusion are left
sided chest pain, rapid heartbeat, and shortness of breath, sweating and low blood
pressure.
Heart
June 2004 Version 1
Substantially recovered
17
€15,100 to €17,000
PIAB Book of Quantum
Lung
The vast majority of lung contusion cases occur in motor vehicle accidents. It occurs
usually from blunt trauma and severe decelerating forces.
Provided there is no complications and sufficient breathing can be maintained, a
satisfactory recovery results.
Lung lacerations can occur through blunt trauma or penetrating injuries or from injuries to
the rib cage. The lung has many veins and as such, lacerations may result in profuse
bleeding.
The normal treatment is to use a tube to drain the fluid and air and to keep the lung
expanded to prevent it collapsing.
Lung contusion
Substantially recovered
€13,800 to €16,900
Punctured Lung
Substantially recovered
€13,900 to €21,700
Kidneys
Kidney injuries are relatively rare as they are well protected by the ribcage. Most kidney
injuries are within these ranges usually classified as contusions, lacerations,
haematomas and ruptures.
Contusions are regarded as mild injuries and are treated conservatively with rest and
observation. More severe contusions might involve a period of hospitalisation.
Antibiotics may also be prescribed. Contusions normally resolve without any residual
problems over a four to six week period.
Haematomas are treated conservatively where possible, along with observation to
ensure the haematoma is not expanding or haemorrhaging, in which case surgical
evacuation and bleeding control is required.
Contusion or haematoma
Laceration
Total loss of one kidney
June 2004 Version 1
€12,500 to €19,800
€16,600 to €23,400
€43,100 to €84,900
18
PIAB Book of Quantum
Bowels and Digestive System
The normal treatment for injuries to the intestines is surgery to open the abdomen
(laparotomy). When the damaged area is located, lacerations or perforations are treated
by suture or in some cases with a patch. External drainage is done simultaneously.
Major damage might require removal of the damaged section and then rejoining the
ends.
Injuries to the colon include lacerations, bruising within the walls of the colon. Injury can
occur to the colon itself or to its mesentery attachment. Blunt and penetrating trauma is
the most common causes of injury.
Treatment of colon injuries includes primary closure, partial removal and colostomy.
Primary closure is used mainly for smaller wounds and involves suture closure.
Colostomy is the surgical opening from the colon to the abdominal wall to create an
outlet for body waste. Colostomy may be temporary or permanent.
Substantially recovered
€16,600 to €27,200
Temporary Colostomy
€40,900 to €50,300
Serious and permanent conditions
(permanent colostomy)
€51,500 to €113,000
Bladder
Bladder injuries, which mostly occur from blunt trauma, are more likely to occur when the
bladder is full rather than when it is empty. When empty, the bladder lies behind the
pelvis and is therefore well protected by the pelvis but when full, it rises up into the lower
abdomen and becomes vulnerable to trauma. When empty however it is still vulnerable
to injuries that result in fractures of the pelvis.
Bladder contusions are bruising of the bladder wall. These may sometimes be described
as interstitial injuries. Minor bladder contusions require no specific treatment. If blood in
the urine is present (hematuria), observation or catheterisation may be required. Severe
contusions may even necessitate the use of an indwelling catheter for a number of days.
Bladder contusions resolve without any residual urinary dysfunction.
June 2004 Version 1
19
PIAB Book of Quantum
Bladder contusion
Substantially recovered
€13,000 to €20,000
Ureter
Substantially recovered
€16,600 to €26,400
Loss of function or removal
€18,400 to €107,000
Spleen
The spleen is a commonly injured abdominal organ being particularly susceptible to blunt
trauma, and motor vehicle accidents are the leading cause of spleen injuries.
The most common types of spleen injury are laceration and rupture. Rupture generally
occurs at the time of accident but may also be a late rupture. Spleen injuries often occur
in association with other injuries such as rib fractures but also frequently also occur in
isolation.
Haematoma /
Laceration
Substantially recovered
€16,600 to €26,500
Total Loss
Loss of function or removal
€50,800 to €53,200
Hernias
A hernia is a forcible protrusion of a body organ or body tissue through another structure.
Hernia as an injury in most cases will be encountered as a work related injury suffered
through lifting.
An inguinal hernia is a herniation in the groin area and is the most common type of
hernia; it may be unilateral or bilateral (one sided or both sides). Other types of hernia
include femoral hernias, umbilical hernias, parumbilical hernias and ventral hernias.
A hernia may also be strangulated hernia (where the blood supply to the protruding
organ or tissue has been cut off), obstructed (blocks the intestine), reducible (it can be
reduced (pushed back) by manual manipulation) or irreducible / incarcerated (it cannot
be reduced by manual manipulation and as such requires surgical intervention).
Substantially recovered
€11,000 to €19,900
Significant ongoing
€18,100 to €72,200
Severe permanent condition
€64,700 to €76,000
June 2004 Version 1
20
PIAB Book of Quantum
Leg Injuries
Leg Amputations
Complicated traumatic amputations are ones involving delayed treatment, delayed
healing or major infection. Some necessitate stump revision or develop phantom limb
symptoms
Loss of both legs
€130,000 to €180,000
Both legs below the knee
€121,000 to €171,000
Both Feet
€103,000 to €162,000
One leg above the knee
€104,000 to €136,000
One leg below the knee
€94,600 to €127,000
One Foot
€81,000 to €120,000
Big Toe
€31,800 to €49,900
Any Toe other than the Big Toe
€18,200 to €30,000
Hip/Pelvis
Soft Tissue
Like other sprains, hip sprains are sometimes classified in grades: mild sprains involve
some stretching of ligaments, moderate sprains involve partial rupture of a ligament
while severe sprains involve complete rupture of a ligament.
Substantially recovered
up to €23,300
Significant ongoing
€16,100 to €47,100
Serious and permanent conditions
€39,400 to €69,400
Dislocations
June 2004 Version 1
21
PIAB Book of Quantum
More serious injuries may involve an element of severe ongoing dysfunction as well as a
high risk of degenerative change.
Substantially recovered
€19,400 to €36,500
Significant ongoing
€26,300 to €62,700
Serious and permanent conditions
€49,600 to €84,200
Fractures
Where the fracture is isolated, i.e. fractured in a single place, prognosis is usually
excellent and an assessment in the lower bracket would usually be appropriate. Serious
and permanent conditions pelvic fractures such as those that involve fractures in more
than one place and hence disruption of the pelvic ring are treated with external or
internal fixation, via a laparotomy and will attract higher compensation. The fracture may
involve complications, such as, as is quite common in males, injuries to the bladder and
urethra. In females there can be a risk of complications in childbirth.
Other risks to be considered are degenerative changes and the possible need for future
surgery, for example hip replacement, a higher compensation may be applicable.
Substantially recovered
€19,600 to €35,300
Significant ongoing
€26,700 to €77,200
Serious and permanent conditions
€49,600 to €87,200
Upper Leg (femur bone)
Fractures
Serious injuries include those where a risk of future arthritis exists and the level of that
risk, the recovery period, treatment type and duration and what complications exist, for
example fracture non-union or limb shortening. Fractures that involve a joint are usually
considered more complicated than others due to the increased impact on limb
movement.
Substantially recovered
€19,600 to €35,000
Significant ongoing
€26,700 to €60,000
Serious and permanent conditions
€49,200 to €79,800
June 2004 Version 1
22
PIAB Book of Quantum
Knee
Soft Tissue
Knee sprains are sometimes classified in grades: mild sprains involve some stretching of
ligaments; moderate sprains involve partial rupture of a ligament while severe sprains
involve complete rupture of a ligament. The majority of sprains require only conservative
treatment and result in a complete resolution of symptoms with the Serious ruptures may
result in surgical intervention and possible ongoing discomfort.
Substantially recovered
up to €28,400
Significant ongoing
€15,600 to €58,300
Serious and permanent conditions
€42,200 to €78,300
Dislocations
Severity depends on whether the dislocation is reduced spontaneously or whether a
closed or open procedure had to be performed. Complications such as nerve and vein
damage may also arise
Substantially recovered
€17,000 to €35,500
Significant ongoing
€23,300 to €65,400
Serious and permanent conditions
€48,600 to €84,500
Fractures
More serious cases are those involving patella fractures where a severe level of ongoing
disability exists, more common in displaced fractures. Displaced fractures usually
require surgical treatment that may take a number of forms, including tension band
wiring or removal of part or all of the knee cap (patellectomy).
Substantially recovered
€16,200 to €36,000
Significant ongoing
€22,400 to €64,200
Serious and permanent conditions
€48,200 to €83,800
June 2004 Version 1
23
PIAB Book of Quantum
Lower Leg (tibia and fibula bones)
Fractures
This category includes fractures to both the tibia and fibula. A fracture to the fibula is
usually not as severe as that of a tibia. Fractures that involve a joint are usually
considered more complicated than others due to the increased impact on limb
movement.
Complications may arise such as fractures of both bones, which may include vein
damage, soft tissue damage, malunion, delayed union and non-union and joint stiffness
at either the ankle or knee or both. Open fractures (where the bone(s) break the skin)
may be further complicated by infection. Peripheral nerve damage (peroneal nerve) may
also be associated with the fractures.
Substantially recovered
€15,400 to €34,600
Significant ongoing
€21,300 to €73,900
Serious and permanent conditions
€47,500 to €87,300
Ankle (including Achilles Tendon)
Soft Tissue
Any of the ankle/foot ligaments may be partially ruptured (sprained) or involve complete
rupture of the ligaments. They may be injured in isolation, or together.
Both ankle and achilles tendon sprains are commonly classified as mild, moderate and
severe. Mild sprains involve some stretching of ligaments; moderate sprains involve
partial rupture of a ligament while severe sprains involve complete rupture of a ligament.
More seriously, a complete rupture of the Achilles tendon may occur
Substantially recovered
up to €19,800
Significant ongoing
€10,000 to €49,400
Serious and permanent conditions
€37,200 to €70,400
June 2004 Version 1
24
PIAB Book of Quantum
Dislocations
Ankle dislocations normally heal without ligament instability and generally have a good
outcome with little, if any residual disability. Where the dislocation involves open
wounds, infection is a constant concern and a considerable permanent disability may
arise.
Substantially recovered
€17,400 to €29,000
Significant ongoing
€24,200 to €58,200
Serious and permanent conditions
€50,700 to €78,500
Fractures
Three bones form the ankle joint; the distal (bottom end) tibia bone (known as the medial
malleolus), the distal (bottom end) fibula (known as the lateral malleolus) and the talus
bone (one of the tarsal bones in the foot). Fractures that involve the joint are usually
considered more complicated than others due to the increased impact on limb
movement.
The more severe injuries involve displacement and ligament damage (which may be
treated with either open or closed reduction).
Substantially recovered
€16,700 to €35,300
Significant ongoing
€23,300 to €64,200
Serious and permanent conditions
€49,700 to €84,200
June 2004 Version 1
25
PIAB Book of Quantum
Foot
Foot sprains can result from twisting motions or hyperextension forces. The mid-foot
joints are the areas most often subject to sprains and strains. Foot sprains can be acute
or chronic.
Foot sprains are treated with the application of ice, possibly the use of walking aids
during the acute phase, physiotherapy, protective taping, anti-inflammatory medication
and possibly analgesics for pain depending on the severity of the injury.
Soft Tissue
Substantially recovered
up to €19,800
Significant ongoing
€10,000 to €49,400
Serious and permanent conditions
€37,200 to €70,400
Substantially recovered
€14,000 to €25,900
Significant ongoing
€19,700 to €55,400
Serious and permanent conditions
€46,100 to €75,900
Dislocations
Fractures
Simple foot fractures, non-displaced and even some displaced often do not need
reduction. Recovery is usually fully achievable but some are. Serious fractures are
those where prolonged treatment, permanent disability and/or future complications such
as arthritis exist.
Substantially recovered
€14,900 to €48,900
Significant ongoing
€20,800 to €59,200
Serious and permanent conditions
€47,100 to €80,500
June 2004 Version 1
26
PIAB Book of Quantum
Crush Injuries
A crush injury is a serious type of soft-tissue injury and may include fracture, vein and
nerve damage.
Treatment of these major soft-tissue injuries may involve vein repair, nerve repair,
debridement, repeated wound irrigations and skin grafts. Amputation may become
necessary unless the neurovascular viability of the limb or part thereof is restored. Any
associated fractures and other soft tissue damage such as ligament and tendon injuries
will also require repair.
Substantially recovered
€12,100 to €25,100
Significant ongoing
€13,000 to €66,000
Serious and permanent conditions
€16,000 to €84,200
Toes
Dislocation
The majority of toe dislocations are relatively minor where reduction is achieved by
manipulation and followed up with a period of foot immobilisation in a cast. If reduction
cannot be achieved by closed methods, an arthrotomy (surgical opening of a joint) may
be required to achieve reduction.
Big Toe
Substantially recovered
€11,400 to €31,100
Significant ongoing
€12,600 to €34,900
Serious and permanent conditions
€20,300 to €41,700
Substantially recovered
€11,300 to €15,000
Significant ongoing
€11,900 to €17,900
Serious and permanent conditions
€15,000 to €20,300
Toes
June 2004 Version 1
27
PIAB Book of Quantum
Fractures
Most toe fractures heal satisfactorily with conservative treatment. In some rare cases,
surgical intervention is required, such as open reduction or a level of disability
permanently may occur
Big Toe
Substantially recovered
€11,800 to €16,700
Significant ongoing
€13,200 to €24,700
Serious and permanent conditions
€20,800 to €32,300
Substantially recovered
€11,300 to €16,100
Significant ongoing
€11,900 to €19,000
Serious and permanent conditions
€14,900 to €21,600
Toes
June 2004 Version 1
28